'Shame on us nurses'

 
Nurse with elderly patient

Following the Care Quality Commission's recent report on what it called "alarmingly" poor care for elderly hospital patients, leading nurse Prof Ian Peate says in this week's Scrubbing Up that the profession should look again at how it trains people to look after older people.

Once again we read about the disgraceful care of our elderly and frail population and once again I cringe with embarrassment as I read how we abuse the people who we have the privilege to care for.

Yes I know there are some excellent examples of high quality outstanding care provided to people. But there is something seriously wrong here.

Nursing is well on its way to setting minimum standards for a degree level nursing programme and justifiably so, given the complexities of care and the demands the public rightly make in insisting on high quality, safe and effective care.

The Nursing and Midwifery Council (NMC) regulates nurses and midwives in the UK.

It sets standards for education, attempting to ensure that nurses possess the right skills and qualities when they start work as a qualified nurse.

What the NMC does not do is stipulate any mandatory requirements for elderly care. They leave this up to the individual educational institutions, so each will approach the teaching of elderly care in a variety of ways.

The time has come for the NMC to compel those running courses to stipulate how much time should be dedicated to the care of the elderly, in practice and theory.

There is a need to ensure that students of nursing - our future staff nurses who will be looking after me when I am older - are able to care confidently and competently for older people - geriatrics.

'High touch' - not high-tech

The art and science of gerontology has all but gone and this is a pity.

As a nursing student I was privileged to take a course that instilled in me the skills required to care for geriatrics patients, responding to their unique needs as people who have a number of concurrent illnesses and take a variety of medications.

If nurses get the care of older people right by applying the theory to practice, paying attention to feeding them and providing them with fluids, washing and cleaning them when they are unable to wash themselves, communicating with them and encouraging them through caring, kindness and compassion then caring for other patients will come naturally.

Start Quote

We need to say sorry to our patients and to tell them what we are going to do to get it right”

End Quote Prof Ian Peate

These are high level skills that require the nurse to apply scientific principles to the art of caring.

As a student I was assessed, on the job - by an experienced nurse - in caring for geriatric patients. But that specific check is no longer required.

We should not be ashamed, embarrassed or made to feel politically incorrect when using the term geriatric.

It is a speciality, with care provided by skilled practitioners, on the geriatric ward as opposed to a busy acute medical ward where high-tech is favoured and preferred over "high-touch".

We have witnessed our medical colleagues embrace so-called "soft skills" (communication skills, a good bedside manner) through their improved undergraduate education.

NMC take heed.

Demand the curriculum you validate has explicit elements of geriatric care in them, in the classroom and on the ward; direct that no student will progress if they do not pass the an elderly care part of their course; continue to reinforce the need for all staff to speak out when they witness substandard or abusive care but also insist that those who speak out are supported.

Shame on us nurses.

We need to say sorry to our patients and to tell them what we are going to do to get it right, and we need to be brought to account each time we fail to provide care that is compassionate, kind and humane.

 

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  • rate this
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    Comment number 289.

    I don't agree about staffing levels or pay, it appears to be how they are taught. My lad had a large part of his intestines removed due to Crohn's disease. When I visited and asked a nurse for help to raise him in the bed I was told he could do this himself ?! Too much emphasis on degrees and not enough on care. My aunt was a matron for many years so I do know how hospitals used to be run.

  • rate this
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    Comment number 288.

    I thought all nurse were mother Theresa's.

    Then I had an op early this year and witnesses some shifts who were callous and uncaring, espciallly with dying people. Itsickened me, but like the others patients I was too weak and dependant after an op to do anything.

    I am sorry to say this was most evident amoungst older nurses; in fact the young ones were lovely and as shocked as me I thnk.

  • rate this
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    Comment number 287.

    It's a crime that people responsible for staffing are allowed to understaff wards as much as they do especially for the elderly. The elderly can take a huge amount more effort not to mention abuse often received from them. It's dead easy for a patient to cry abuse! but until you've nursed the elderly you don't realise how trying it can be. I've been bitten had my glasses broken but we struggle on

  • rate this
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    Comment number 286.

    @277.
    Tigerlily Bane
    21st October 2011 - 23:22

    273.adzcliff

    I'm disappointed in you. My wife's a student, having been a teacher of children with behavioural difficulties (and then dep-headmistress). Her course run 46wks of the year, with half that time in clinical placement. This is NOT a little bit - it's the same as my first wife did 23 years ago. Assessment is by nurses - in both settings!

  • rate this
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    Comment number 285.

    282.sarah
    I am currently a student nurse, having been a carer for 20 years. I truly believe that all students should have some care background, and not be allowed to apply until they do

    =>Back in the day this happened. Student nurses worked on the wards as well as classroom work. They were assessed by matrons, ward sisters and examiners. Lazy or uncaring people never made SRN

  • rate this
    0

    Comment number 284.

    I've just made negative comments about nursing in 2011, but to be constructive, even though personal experience supports my arguments, I would like to say I have also seen 1st class nursing in Southport recently. Strange as it may seen, logging activity is is an enormous drain reaching the state where staff do more typing then nursing. There has to be a better way, perhaps voice recording

  • rate this
    0

    Comment number 283.

    278.joanna
    Recent press has led to me decide leave the NHS


    =>A great shame. I agree NHS hospitals don't have anywhere near enough nurses, certainly not to look after the elderly especially now that care plans have to be written, read, understood & with supporting documentation updated the whole time. People who decide staffing should be made to work a few 12hr+ shifts then they'd know.

  • rate this
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    Comment number 282.

    I am currently a student nurse, having been a carer for 20 years. I truly believe that all students should have some care background, and not be allowed to apply until they do. I have worked alongside other students who have no previous experience and it shows. People skills cannot be taught in a classroom, only experience will give these.

  • rate this
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    Comment number 281.

    Two points. Older people are not a homogeneous group as the term 'the elderly' implies. They are people who happen to have lived longer, not a seperate species to be treated differently, passive, incoherent and all exactly the same.
    Good care is about treating others as you yourself would like to be treated, which I doubt is being patronised and seen as a stereotype.

  • rate this
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    Comment number 280.

    275.Agent96
    Should we not try to support those who spend their lives caring for others, and not try to totally destroy their morale

    =>Absolutely. Can you imagine other professionals like doctors, accountants or barristers putting up with the haranguing that nurses get? They are massively overstretched,considering the elderly that DO need nursing care need lots more time and patience

  • rate this
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    Comment number 279.

    Nurses don't nurse, they are now deputy doctors. When they were nurses people supported the NHS 100%. Recently those with reason to complain always began with "The nurses were lovely, but...Not any more. The NHS is its people, with most of the resources spent on meds and more so wages. Like too many public sector groups, making the job a profession has changed the ethos and not for the better.

  • rate this
    +2

    Comment number 278.

    In response to thet comment from Famicon. Your comment is a sweeping statement. I have worked as a nurse for the last 10 years and am still waiting for someone to listen when we scream WE DO NOT HAVE ENOUGH STAFF. We often work 12hr shifts with no break & compete with the ever increasing volume of paperwork which we stay beyond shift to complete. Recent press has led to me decide leave the NHS.

  • rate this
    +1

    Comment number 277.

    273.adzcliff
    I still don't understand why people are blaming degrees for their bad healthcare experiences. Can someone please explain how these university courses are supposed to sap the humanity out of nurses?

    Easy. Nurse training was once apprentice-like/hands on supplemented by classroom training. Now it's lecture theatre training supplemented by a little bit of practical work.

  • rate this
    +1

    Comment number 276.

    As learning disability student nurses in the 90s, we were seen as the Cinderella service. I believe our training programme made us the best caring nurses; enduring realistic role play as patients, it was an experience we never forgot & shaped our future empathetic qualities not often seen in other disciplines. I know, in light of experiences as a carer for my severely disabled partner!

  • rate this
    +1

    Comment number 275.

    On one hand nurses are lazy. On the other they are overstretched. For a profession on poor pay, antisocial hours, a profession that never stands up for itself, to be attacked by the government on pensions, managers on job cuts, the media on care and continually by the public. Should we not try to support those who spend their lives caring for others, and not try to totally destroy their morale

  • rate this
    +2

    Comment number 274.

    Caring for the elderly needs the patience of a saint. Though nurses are paid a little better than carers, carers are generally hired on the minimum wage which in no way reflects the special qualities needed to develop a rapport with elderly people. They have communication problems, are vulnerable in that they can't robustly complain.Private homes have about 1 nurse to 20 patients, not so the nhs

  • rate this
    0

    Comment number 273.

    I still don't understand why people are blaming degrees for their bad healthcare experiences. Can someone please explain how these university courses are supposed to sap the humanity out of nurses? Presumably the memorable and excellent doctor is a compassionate and a skilled communicator, but I'm not sure of one yet who had to forgo their medical training to acquire/apply these human skills?

  • rate this
    +1

    Comment number 272.

    My wife is a nurse, and i am a teacher. Between us our current and previous jobs have been in the NHS, Education, Military and Civil Service. If there's one thing i've learnt; it's that 'the public' is really unqualified to comment on it. If 'the public' had even 1% of the awareness a nurse would have about issues affecting nursing care, then half these comments wouldn't be here. Armchair experts.

  • rate this
    +2

    Comment number 271.

    Famicom...it's not a lie..your comment makes me feel sad you feel that way. You must have had some bad experience. However as a nurse who wants to care for my patients in a holistic individualised way (as I was trained to do) I find my self struggling to cope with the work load having to prioritise life sustaining treatment over caring needs. How can one nurse care for 28 patients?

  • rate this
    +1

    Comment number 270.

    Yet another example where we have taken our eye off the ball in the UK in the mistaken belief that education to degree level is a requirement above all else. Nurses should be carers first and foremost.
    Britains obsession of university education is producing highly qualified dole queues and over educated & dissatisfied workers. We need to value practical skills as well as graduates.
    ps. I'm retired

 

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